Pathologia最新文献

{"title":"Pathology gradual assessment of colorectal anastomosis","authors":"A. Klymenko, V. Klymenko, I. Y. Kononenko","doi":"10.14739/2310-1237.2022.2.262454","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.2.262454","url":null,"abstract":"Aim: to analyze the state of the colorectal anastomosis after laparoscopic and open resection of the sigmoid and rectum in patients with colorectal cancer and to develop a unified grading of pathological changes in the anastomosis during its laparoscopic and videorectoscopic assessment.\u0000Materials and methods. Results of the treatment of 79 patients who underwent resection of the rectum and sigmoid colon due to adenocarcinoma were analyzed. Patients were divided into two groups. The first group consisted of 34 (43.04 %) patients, whose treatment method was laparoscopic resection of the sigmoid and rectum (main group). The second group consisted of 45 (56.96 %) patients who underwent laparotomic resection. A stapler colorectal anastomosis was formed in both groups. The patients had II–III stages of the oncological disease without prior chemotherapy or radiotherapy in the anamnesis. During the operation visual assessment of the applied anastomosis was performed taking into account both external and internal characteristics. For external examination visual assessment of the anastomosed ends from the side of the serous membrane and a pneumohydrotest were used, for internal – an ordinary 10 mm laparoscope was inserted into the anus with CO2 insufflation at the level of 6 mm Hg and a visual assessment was carried out from the side of the mucosa. According to the received data, an original gradation of pathological changes in the colorectal anastomosis and recommendations for the prevention of its failure were developed.\u0000Results. The developed technique for assessing and gradation of pathological changes in colorectal anastomosis made it possible to identify and eliminate suturing defects in 19 (24.05 %) patients, to eliminate stitching defects, control bleeding, identify ischemic zones of the anastomotic ends and improve total results of the treatment. One patient had anastomotic failure on the third day after operation. This case required reoperation with removal of the anastomosis and formation of the terminal colostomy. There were no lethal cases in both groups. Usage of additional methods for assessing the anastomosis is time-consuming and important in detecting pathological changes in the colorectal anastomosis.\u0000Conclusions. The gradation of pathologic changes in the colorectal anastomosis should be comprehensive with an assessment of not only its external characteristics but also internal ones using videorectoscopy and allows to reduce the risks of colorectal anastomosis failure. The average number of points in the combination of laparoscopic and videorectoscopic evaluation is higher than in the laparoscopic one alone, but there is no statistical significance (U = 884.5; P = 0.071). This makes it possible to use the proposed grading system both in laparoscopy and in open surgery with the same results. There is no statistically significant difference in the number of detected anastomotic complications between open and laparoscopic resection of the ","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"86 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81257512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisystem inflammatory syndrome, probably associated with SARS-CoV-2, complicated by thrombus in the right atrium, in a child","authors":"O. Usachova, O. V. Konakova, Ye.A. Silina, N. Vorobiova","doi":"10.14739/2310-1237.2022.2.255603","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.2.255603","url":null,"abstract":"Aim. Clinical case report of multisystem inflammatory syndrome, probably associated with COVID-19 and complicated by large thrombus in the right atrium in a child highlights the problems of monitoring, treatment, and the possibility of their solution.\u0000Presentation of a clinical case. We demonstrate one of the cases of multisystem inflammatory syndrome (MIS-C), which meets WHO criteria. In a child with a severe course of the disease and symptoms of hyperinflammation, on the 16th day from the onset of the disease, a positive effect was registered on the introduction of human normal immunoglobulin for intravenous administration and glucocorticosteroids. But on the day 27 of the disease, despite administration of anticoagulant therapy, a large blood clot was found in the right atrium cavity. Operation was performed with removal of the thrombus from the right atrium under artificial blood circulation and the child was discharged in satisfactory condition to continue treatment in an outpatient setting on the day 56 of the disease.\u0000Conclusions. Timely diagnosis of MIS-C in children with fever, signs of inflammation and organ dysfunction during the pandemic spread of COVID-19 and reasonable administration of intravenous immunoglobulin and steroids may reduce the inflammatory response and improve the prognosis. It is also important to conduct population-based prospective studies to optimize thromboprophylaxis in children with COVID-19 and MIS-C.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86405436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic signs of gastroesophageal reflux disease with different hiatal hernias types","authors":"A. Nykonenko, Ye. I. Haidarzhi, О. М. Kiosov","doi":"10.14739/2310-1237.2022.1.252191","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.252191","url":null,"abstract":"A hiatal hernia occurs in 83–94 % of patients with gastroesophageal reflux disease (GERD). Difficulties in diagnosing endoscopic signs of gastroesophageal reflux with combination of the most common hiatal hernia types remain relevant. Untimely and inaccurate endoscopic interpretation of these pathological changes significantly reduces the effectiveness of treatment.\u0000The aim of the research was to study the endoscopic signs of gastroesophageal reflux disease with the most common hiatal hernia type I and type III.\u0000Materials and methods. The examination results of 153 patients with GERD and the most common hiatal hernia type I and type III at the stage of preparation for antireflux surgical treatment were analyzed. The age was 54.5 ± 11.3, there were 48 (31.4 %) men, 105 (68.6 %) women. In Group I – 85 patients with GERD and type I hiatal hernia, in Group II – 68 patients with GERD and type III hiatal hernia. A complete preoperative examination necessarily included endoscopy with chromoendoscopy (mainly NBI or FICE), biopsy from suspicious foci of the gastric mucosa and the lower third of the esophagus followed by histological analysis. Statistical processing and mathematical analysis of the obtained results were performed using the Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J). For comparative analysis the arithmetic mean and standard deviation were calculated and presented as M ± s. Differences between groups were assessed using the sub-module “Difference tests” in the module “Basic statistics and tables”. Differences at P < 0.05 were considered statistically significant.\u0000Results. In both groups, non-erosive forms of gastroesophageal reflux disease prevailed: 57 (67.1 %) and 39 (57.4 %) patients respectively. Both in Groups I and II, among the erosive forms there were mainly LA A stages of esophagitis – 20 (23.5 %) and 17 (25.0 %). СLE signs of the esophageal mucosa prevailed in Group I – 16 (18.8 %) patients, in Group II – 5 (7.4 %) patients. The proximal edges of the gastric folds, which are visualized in all patients, were considered the reference point for the true esophageal-gastric junction. Complicated course of GERD was noted in both groups of patients.\u0000Conclusions. Endoscopic signs of GERD with hiatal hernia type I or type III have characteristic features, the severity of which manifestation does not depend on the type. A reliable indicator of the true esophageal-gastric junction location is the proximal edge of the gastric folds. Complicated course of GERD occurs in both groups: Barrett’s esophagus and Schatzki’s ring predominate in the Group I, strictures and ulcers of the esophagus – in the Group II.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"15 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88631968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating effect of HERV-W ENV on peripheral blood monocytes in patients with different types of multiple sclerosis","authors":"O. Koliada, N. Vdovichenko, T. Koliada, O. Tupotilov","doi":"10.14739/2310-1237.2022.1.240436","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.240436","url":null,"abstract":"The aim of the study was to determine the effect of the HERV-W ENV glycoprotein on the functional and metabolic characteristics of intact and stimulated peripheral blood monocytes, depending on the type of multiple sclerosis (MS), which can contribute to our understanding of their pathogenetic role in the development of neurological disorders and to design of novel therapeutic agents.\u0000Materials and methods. To determine the reserve capacity index (Rci) of cytokine production, HERV-W ENV glycoprotein, E. coli lipopolysaccharide (LPS) or ssRNA40/LyoVec were added to the monocyte-enriched cell suspension as agonists of TLR4 and TLR7/8. The study also included the evaluation of arginase activity in cell lysates of the monocyte fraction. The study involved 37 patients with relapsing-remitting type and 19 patients with progressive type of MS. The control group included 32 healthy individuals.\u0000Results. In patients with MS of both groups, the reserve capacity of monocytes to produce IL-1β was lower than in healthy individuals, while the reserve capacity to produce TNF-α and IL-10 was almost twice as high as in the control group. This index for IL-1RA in monocytes obtained from the group with progressive MS and stimulated with HERV-W ENV was 2 times lower than the control; thus increased IL-1β values provoke chronic inflammation. The highest arginase activity in patients with relapsing-remitting MS was observed when monocytes were cultured with HERV-W ENV and LPS. In patients with progressive MS, during the cultivation of monocytes with LPS, arginase activity was significantly reduced relative to the control.\u0000Conclusions. The results obtained indicate functional and metabolic changes in peripheral blood monocytes upon stimulation with TLR4 and TLR7/8, which may be associated with the disease course. In progressive MS, stimulation with HERV-W ENV leads to an imbalance of pro-inflammatory and regulatory cytokines, contributing to a chronic inflammation and, as a consequence, to a more severe course of the disease.\u0000 ","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"34 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81045112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of successful treatment of an extremely preterm infant with necrotic enterocolitis complicated by sepsis of bacterial and fungal etiology","authors":"M. Kurochkin, A. Davydova, M. Makarova, I. H. Denysenko, Yu.V. Horodkova","doi":"10.14739/2310-1237.2022.1.252134","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.252134","url":null,"abstract":"The aim. To acquaint medical practitioners with the case of successful surgical treatment and intensive care of a extremely preterm infant with necrotic enterocolitis, complicated with intestinal perforation and sepsis of mixed bacterial and fungal etiology.\u0000Materials and methods. The child was treated in the Neonatal Anesthesiology and Intensive Care Department of Communal Non-commercial Enterprise “City Children’s Hospital No. 5” of Zaporizhzhia City Council. Blood analyses, microbiological, X-ray and ultrasound examinations were performed by indications using the hospital equipment.\u0000Results. An extremely preterm, very low birth weight infant underwent nine traumatic surgical interventions for NEC with gastric and intestinal perforation, diffuse peritonitis, and adhesive intestinal obstruction. The child’s condition was complicated by sepsis of mixed bacterial and fungal etiology. Preoperative preparation included antibacterial therapy, infusion therapy with modern balanced polyionic solutions, and inotropic support.\u0000During and after surgical interventions, the child underwent multimodal combined anti-stress anesthesia with the use of neuroaxial blocks, prolonged MLV, antibacterial therapy with modern drugs according to the de-escalation principle and microbiological peculiarities of the department, antifungal therapy with reserve drugs, immune replacement therapy, parenteral nutrition and infusion program using blood products according to indications. Despite the child’s critically severe condition and morphofunctional immaturity, the child has survived, has no neurological deficit, and has gained four times his initial body weight.\u0000Conclusions. The use of multimodal combined anesthesia with caudal-epidural blocks in the intra- and postoperative periods, adequate respiratory and hemodynamic support, parenteral and early enteral feeding in a deeply premature baby with NEC probably contributed to antinociceptive protection and positive treatment outcome after 9 urgent operations. The reserve antibiotics and antifungal drugs prescription according to de-escalation principle, considering the sensitivity of the bacterial flora to them, bacteriological monitoring and immune replacement therapy, had a positive result in the treatment of sepsis, which complicated the course of NEC in the newborn baby.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"59 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84793624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemical study of the brain glutamine synthetase expression in the rat septic model","authors":"T. Shulyatnikova, V. Tumanskiy","doi":"10.14739/2310-1237.2022.1.251248","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.251248","url":null,"abstract":"Severe sepsis is accompanied by multiple organ dysfunction where acute liver failure (ALF) plays one of the most critical roles. The principal sign of acute hepatic encephalopathy accompanying ALF is ammonia induced edema of astrocytes. In case of ALF in sepsis, one can suppose increase in systemic and brain ammonia. Astroglia are target cells for ammonia metabolism as they are principal source of glutamine-synthetase (GS). Previous studies have reported that ALF stimulates increase in astroglial GS which correlates with deterioration of the animal state.\u0000The aim of the study was to determine the level of glutamine synthetase expression in different brain regions of rats in the conditions of experimental sepsis.\u0000Materials and methods. The study was conducted in Wistar rats: 5 sham-operated (control) animals and 20 rats with cecum ligation and puncture (CLP) septic model. Immunohistochemical study of GS expression was performed in the cortex, white matter, hippocampus, thalamus, caudate nucleus/putamen in the period of 20–48 h after CLP.\u0000Results. Starting at 12th h after CLP, operated animals displayed progressive impairment finished by profound lethargy and respiratory failure. Between 20–38 h, 9 animals expressed final mentioned symptoms and were euthanized (CLP-B, non-survived), 11 rats displayed less expressed suffering up to 48 h (CLP-A, survived). At 23 h in CLP-B and 48 h in CLP-A rats, liver tissue displayed morphological signs of the focal irreversible damage which was aggravated with time after CLP which could be observed dynamically in non-survived group. Both CLP-A and CLP-B rats showed gradual elevation of GS in all studied brain regions. From 24 to 38 h after CLP, non-survived animals showed significant region-specific dynamic increase in GS expression: in the cortex – by 69.35 %, hippocampus – by 53.6 %, thalamus – by 50.0 %; with the most substantive elevation in the cortex – 1.69-fold increase compared to control.\u0000Conclusions. In CLP model, 24 h after operation there is significant dynamic increase in GS level in the cortical, hippocampal and thalamic regions of the rat brain with the most prominent in the cortex. Heterogeneous increase in GS indicates regions more or less vulnerable for incoming systemic agents as well as region-specific reactiveness of the brain tissue, including local astroglia, to these factors in septic conditions. Morphological signs of sepsis-associated liver damage preceding significant increase in the brain GS by 1 h, might suppose addition of the liver failure to the course of sepsis which is accompanied by increased level of hepatogenic toxins (presumably including ammonia) in the blood and in the brain parenchyma by 23 h after CLP. The latter might propose an active implication of hepatogenic detrimental agents in sepsis pathophysiology and involvement of reactively increased brain GS levels in the complex mechanisms of sepsis-associated encephalopathy.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"10 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83231920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological rationale of mesenchymal stem cells in the local treatment of experimental chronic purulent-necrotic wounds","authors":"S. V. Slobodianyk, S. Khimich, S. Vernygorodskyi, V. Shkolnikov","doi":"10.14739/2310-1237.2022.1.247230","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.247230","url":null,"abstract":"Aim: to study morphological changes in healing of chronic purulent-necrotic wounds in rats with local use of 0.025 % decamethoxine solution and mesenchymal stem cells.\u0000Materials and methods. The experimental study was performed on 120 rats, which were divided into the following groups: I – control (without treatment); II – the use of classical wound healing (0.025 % decamethoxine); III – the use of clones of mesenchymal stem cells from the umbilical cord; IV – the use of clones of mesenchymal stem cells (cloned in inert gases). To assess morphological changes in chronic wounds, fragments measuring 0.5 cm × 1.0 cm × 1.0 cm were cut from the edges, followed by fixation in 10 % solution of neutral formalin. The microspeciments were prepared according to standard methods, histological sections 5–7 μm thick were stained with hematoxylin and eosin, basic brown, picrofuchsin according to van Gieson, Masson trichrome. The monoclonal antibodies (DAKO) with markers of intermediate filaments, mesenchymal cells and myofibroblasts – Vimentin (Clone V9), smooth muscle actin (αSMA, Clone 1A4), transmembrane protein of endothelial, stem cells and embryonic fibroblasts CD34 (Clone QBEnd 10) were used for immunohistochemistry.\u0000Results. The positive dynamics of chronic wounds healing, with the usage of 0.025 % decamethoxine solution only in the early stages (3–7 days) was determined with a decrease in inflammatory cellular infiltration, while MSC and MSC-IG were effective at all stages of research and confirmed by more intensive purification of the wound’s surface from purulent and necrotic tissues, area of the wound reduction, granulation tissue formation and epithelialization acceleration.\u0000Conclusions. The use of MSCs and MSCs-IG creates favorable conditions for the normal course of regenerative processes and epithelialization of wounds with the activation of fibroblasts, which increases the effectiveness of chronic wound healing.\u0000 ","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"24 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81656958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytokines, insulin resistance and arterial wall stiffness in assessing the course of non-alcoholic fatty liver disease","authors":"Y. Stepanov, V. I. Didenko, O. Tatarchuk, I. Konenko, O. Petishko","doi":"10.14739/2310-1237.2022.1.245985","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.245985","url":null,"abstract":"The progression of non-alcoholic fatty liver disease is associated with an increased prevalence of cardiovascular disease.\u0000Aim: to assess the level of cytokines, insulin resistance, arterial wall stiffness during the progression of hepatic steatosis in patients with non-alcoholic fatty liver disease.\u0000Material and methods. 87 patients with non-alcoholic fatty liver disease were examined. Group I consisted of 14 patients without steatosis, group II – 32 patients with steatosis grade 1; III – 30 patients with steatosis grade 2, IV group – 11 patients with steatosis grade 3. The control group consisted of 30 apparently healthy individuals. Steatometry with a quantitative assessment of the grade of hepatic steatosis was performed using a Soneus P7 ultrasound machine. The content of cytokines (interleukin-6, interleukin-10, TNF-α) was determined using an enzyme-linked immunosorbent assay using a Stat Fax 303 Plus analyzer. The level of insulin resistance was determined using the HOMA-IR index.\u0000Results. The content of interleukin-6 in the blood serum of patients of group IV was significantly increased relative to the level in the control group (by 1.8 times, P < 0.05), patients of group I (by 3.2 times, P < 0.05), II group (by 3.0 times, P < 0.05) and group III (2.3 times, P < 0.05). The level of TNF-α increased with the progression of structural changes in the liver and at grade 4 of steatosis its content was increased by 6.4 times (P < 0.05) relative to the level in the control group, by 8.0 times (P < 0.05) relative to group I patients, by 3.4 times (P < 0.05) – group II patients and by 1.8 times (P < 0.05) – group III patients. An increase in the HOMA-IR index by 3.2 times (P < 0.05) was found in patients with moderate steatosis and 3.9 times (P < 0.05) in patients with severe steatosis compared to controls. A correlation was established between the intima-media thickness of the left common carotid artery and the level of TNF-α (r = 0.438; P = 0.006) and the HOMA-IR index (r = 0.557; P = 0.0008).\u0000Conclusions. In patients with non-alcoholic fatty liver disease with progression of the grade of hepatic steatosis, a significant increase in proinflammatory cytokines, insulin resistance and intima-media thickness of the left common carotid artery was found.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"34 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81840345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in reservoir and motor-evacuatory function of the gallbladder in patients with asymptomatic cholecystolithiasis after organ-sparing surgery – laparoscopic cholecystolithotomy","authors":"D. Syvolap","doi":"10.14739/2310-1237.2022.1.254270","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.254270","url":null,"abstract":"Sonographic assessment of gallbladder structure and function in patients with gallstone disease needs further improvement not only to clarify the indications for organ-sparing operations such as laparoscopic cholecystolithotomy, but also to improve the results of surgical treatment of asymptomatic cholecystolithiasis by predicting probable restoration of motor-evacuatory function of the gallbladder and reduction of the number of recurrences of cholecystolithiasis.\u0000The aim of the study was to investigate changes in gallbladder structure and function in patients with asymptomatic cholecystolithiasis before and after laparoscopic cholecystolithotomy.\u0000Materials and methods. The study involved 33 patients with asymptomatic cholecystolithiasis. The majority of patients are women 82 % (n = 27), aged 23 to 54 years, mean age 48.0 ± 11.9 years. And there were 18 % of men (n = 6), aged 25 to 58 years, mean age 46.2 ± 12.4 years. Ultrasound examination of the abdominal organs was performed in all patients using Philips No. MA2540R and LOGIQ General Electric Ser No. 52993WX3 before and after laparoscopic cholecystolithotomy. During the examination, a sonographic assessment of the shape, size, contours, thickness of the gallbladder wall, as well as its relation with surrounding organs and vascular structures was performed. The size of the common bile duct, the number and size of stones in the gallbladder cavity, as well as its motor-evacuatory function were purposefully determined. Statistical processing of the material was performed using the Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J).\u0000Results. Indicators of gallbladder reservoir function before and after laparoscopic cholecystolithotomy did not differ significantly. There was a significant increase in the ejection fraction of the gallbladder from 54.5 ± 2.1 % to 64.4 ± 2.9 % (P = 0.0001) and a reduction in the “latency period” from 15.6 ± 2.5 min to 8.3 ± 1.7 min (P = 0.001).\u0000Conclusion. Adherence to sonographic indications (single gallstones, less than 3 mm wall thickness and ejection fraction over 50 %) in the selection of patients with asymptomatic cholecystolithiasis for laparoscopic cholecystolithotomy allows not only to preserve the reservoir and also improve the motor-evacuatory function of it, which reduces the risk of possible recurrent stone formation in close and long-term periods of observation.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"9 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81287259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative ultrasound assessment of bone tissue in premature newborn twins","authors":"A. Y. Tsymbal, Yu.V. Kotlova","doi":"10.14739/2310-1237.2022.1.252562","DOIUrl":"https://doi.org/10.14739/2310-1237.2022.1.252562","url":null,"abstract":"Multiple pregnancy is associated with a high risk premature newborn twins (PNT) birth and the formation of low bone mass. Determining the state of bone tissue (BT) after birth is important for understanding the dynamics of its changes in the PNTs’ growth.\u0000Aim: to conduct and analyze the results of quantitative ultrasound assessment of BT in PNT.\u0000Materials and methods. In the early neonatal age, 24 pairs of twins and 39 children from singleton pregnancies (SP) born at gestational age (GA) of 30–36 weeks were examined. Pair of twins with a difference in body weight of 5% or more were involved. BT status was determined with an ultrasonic densitometer “Sunlight Omnisense 9000”, measuring SOS, m/s.\u0000Results. In GA up to 34 weeks SOS of BT in both twins did not differ from each other or from newborns from SP of the corresponding GA. In PNT, from 34 weeks of gestation and more, SOS increased (P < 0.05) in siblings with lower body weight compared to bigger one – 2925 (2887; 3036) m/s and 2866 (2801; 2895) m/s, respectively. According to correlations, the body weight of PNT was not determined as a significant factor influencing the state of BT. SOS in PNT had a weak positive correlation (R = 0.29, P < 0.05) with their GA in contrast to the strong direct correlation (R = 0.78, P < 0.05) in newborns from SP.\u0000Among the factors influencing the state of BT according to SOS in PNT, the inverse correlations with the factor of increasing the number of pregnancies (R = -0.59, P < 0.05) and with birth from monochorionic multiple pregnancies (R = -0.57, P < 0.05) were determined.\u0000Conclusions. SOS in children born in GA of 34 weeks and older was 2925 (2887; 3036) m/s in PNT with lower body weight in pairs. This value was higher (P < 0.05) than in bigger siblings and PNT born in GA less than 34 weeks. SOS in PNT had a weak correlation (P < 0.05) with their GA in contrast to children born in the same GA from SP and had no correlation with the body weight of twins. The average correlation (P < 0.05) between low SOS in PNT and the number of previous pregnancies, as well as with birth from monochorionic multiple pregnancies.","PeriodicalId":41645,"journal":{"name":"Pathologia","volume":"21 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80415290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}